Levodopa-responsive parkinsonism following central herniation due to bilateral subdural hematomas.
A 66-year-old man suffered bilateral subdural hematomas progressing to central herniation, despite repeated surgical evacuations. This eventually resolved, leaving him with a severe parkinsonian syndrome that was responsive to levodopa. MRI and CT showed midbrain compression from central herniation, and a follow-up MRI revealed thinning of the pars compacta. The clinical and radiologic evidence suggested that midbrain compression from central herniation was the probable cause of parkinsonism in this patient.
Trosch
R M
RM
Department of Neurology, Yale University School of Medicine, New Haven, CT 06510.
Ransom
B R
BR
D000368:Aged; D004677:Encephalocele / Q000150:complications / Q000209:etiology*; D006408:Hematoma, Subdural / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D010302:Parkinson Disease, Secondary / Q000188:drug therapy* / Q000209:etiology; D014057:Tomography, X-Ray Computed
D007980:Levodopa